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Cited by 117Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesStress Responses and CortisolChild and Adolescent Psychosocial and Emotional Development

Startle response in Generalized Anxiety Disorder

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Ray, William J., Molnar, Christine, Aikins, Deane, Yamasaki, Alissa, Newman, Michelle G., Castonguay, Louis, Borkovec, Thomas D.·2009·Depression and Anxiety
DOI 10.1002/da.20479PMC PMC6707516
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Abstract

BACKGROUND: The main purpose of the present study was to examine the startle reflex in individuals diagnosed with Generalized Anxiety Disorder (GAD) and control participants in terms of three questions. First, is the basic startle reflex modulated by autonomic nervous system (ANS) activation and/or attentional focus? Second, are induced and self-reported emotional states related to the magnitude of the startle response? And third, do individuals with GAD and their controls show differential startle responses? METHODS: Experimental tasks designed to elicit sympathetic and parasympathetic activation and requiring internal and external attention foci were administered to nine individuals with GAP and nine controls. RESULTS: Individuals with GAD showed a greater startle reflex than controls during involvement in tasks that either induced worry or relaxation but not during a baseline period. Startle responses differed in terms of intentional focus but not ANS activity. During baseline and emotional induction, self-reported negative emotionality was significantly correlated with magnitude of the startle response. CONCLUSIONS: These results suggest that negative emotionality at the time of the startle probe is an important determinant. Further, attentional focus plays a more important role in startle modulation than autonomic nervous system manipulation. These results are discussed in relation to negative emotion, focus of attention, and use of the startle response as a measure of change during psychotherapy.

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  • Ray et al. (2009) found that the strength of physiological responses to a novel stimulus was determined more by whether the participant evaluated the stimulus as negative beforehand than by their arousal level prior to stimulus presentation.

    “For example, Ray et al. (2009) found that the strength of physiological responses to a novel stimulus determined more by whether or not the evaluated the stimulus as negative beforehand, than their arousal level prior to stimulus presentation.”

    From How Exactly Do I “Let Go”? The Potential of Using ACT to Overcome the Relaxation Paradox (2014) · cites this paper as Ray et al., 2009

    The Results (Data Analyses; page unavailable) associate larger startle responses with negative self-reported emotion, but also with greater activation during relaxation and worry. The Methods (Procedure; page unavailable) say participants rated how they felt during each task after it ended; they did not evaluate the startle stimulus beforehand. The paper therefore does not establish the claimed comparison with pre-stimulus arousal. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Each new anxious thought is treated as a novel stimulus, whose presence was never allowed and therefore never habituated to, so that the strength of the somatic response does not diminish over time.

    “In a sense, each new anxious thought is treated as a novel stimulus, whose presence was never allowed and therefore never habituated to, so that the strength of the somatic response does not diminish over time (Ray et al., 2009; Wegner, 1994).”

    From How Exactly Do I “Let Go”? The Potential of Using ACT to Overcome the Relaxation Paradox (2014) · cites this paper as Ray et al., 2009

    The Discussion (page unavailable) says startle responses generally decrease with repeated probes and discusses worry as processing distant threat cues. It does not say that each new anxious thought escapes habituation or that the resulting somatic response remains undiminished. Searches for thought suppression and habituation during worry did not establish that mechanism. (LLM, conf=0.74)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 57

  1. [2]Davis M Neural systems involved in fear and anxiety measured with fear-potentiated startle. Am Psychol 2006; 61: 741– 756. 17115806
  2. [4]Graham F Distinguishing among orienting, defense, and startle reflexes In: Kimmel H, van Olst E, Orlebeke J, eds. The orienting reflex in humans. Hillsdale, NJ: Erlbaum; 1979: 137– 167.
  3. [5]Berg K, Balaban M. Startle elicitation: stimulus parameters, recording techniques, and quantification In: Dawson M, Schell A, Böhmelt A, eds. Startle modulation. New York: Cambridge University Press; 1999.
  4. [6]Davis M Are different parts of the extended amygdala involved in fear versus anxiety? Biol Psychiatry 1998; 44: 1239– 1247. 9861467
  5. [8]Rosen JB, Hitchcock JM, Sananes CB, Miserendino MJD, Davis M. A direct projection from the central nucleus of the amygdala to the acoustic startle pathway: anterograde and retrograde tracing studies. Behav Neurosci 1991; 105: 817– 825. 1777104
  6. [9]Diazepam Davis M. and flurazepam: effects on conditioned fear as measured with the potentiated startle paradigm. Psychopharmacology 1979; 62: 1– 7. 35808
  7. [10]Patrick CJ, Berthot B, Moore JD. Diazepam blocks fear-potentiated startle in humans. J Abnorm Psychol 1996; 105: 89– 96. 8666715
  8. [11]Lang PJ. The emotion probe: studies of motivation and attention. Am Psychol 1995; 50: 372– 385. 7762889
  9. [12]Dawson M, Schell A, Böhmelt A. Startle modulation. New York: Cambridge University Press; 1999.
  10. [13]Filion DL, Dawson ME, Schell AM. The psychological significance of human startle eyeblink modification: a review. Biol Psychol 1998; 47: 1– 43. 9505132
  11. [14]Grillon C, Baas J. A review of the modulation of the startle reflex by affective states and its application in psychiatry. Clin Neurophysiol 2003; 114: 1557– 1579. 12948786
  12. [16]Davis M. Pharmacological and anatomical analysis of fear conditioning using the fear-potentiated startle paradigm. Behav Neurosci 1986; 100: 814– 824. 3545257
  13. [18]Grillon C, Ameli R, Woods S, Merikangas K, Davis M. Measuring the time-course of anxiety using the fear-potentiated startle reflex. Psychophysiology 1993; 30: 340– 346. 8327619
  14. [19]Lang PJ, Cuthbert BN, Bradley MM. Measuring emotion in therapy: imagery, activation, and feeling. Behav Ther 1998; 29: 655– 674.
  15. [20]Smith J, Bradley M, Lang P. State anxiety and affective physiology: effects of sustained exposure to affective pictures. Biol Psychol 2005; 69: 247– 260. 15925028
  16. [22]Konorski J Conditioned reflexes and neuron organization. Cambridge: Cambridge University Press; 1948.
  17. [23]Konorski J Integrative activity of the brain. Chicago, IL: University of Chicago Press; 1967.
  18. [24]Cuthbert BN, Bradley MM, Lang PJ. Probing picture perception: activation and emotion. Psychophysiology 1996; 33: 103– 111. 8851238
  19. [25]Bonnet M, Bradley MM, Lang PJ, Requin J. Modulation of spinal relexex: arousal, pleasure, action. Psychophysiology 1995; 32: 367– 372. 7652113
  20. [26]Both S, Everaerd W, Laan E. Modulation of spinal reflexes by aversive and sexually appetitive stimuli. Psychophysiology; 40: 174– 183. 12820858
  21. [27]Cook E Affective individual differences, psychopathology, and startle reflex modulation In: Dawson M, Schell A, Böhmelt A, eds. Startle modulation. New York: Cambridge University Press; 1999.
  22. [30]Graham F Attention: the heartbeat, the blink, and the brain In: Campbell B, Hayne H, Richardson R, eds. Attention and information processing in infants and adults: perspectives from human and animal research. Hillsdale, NJ: Erlbaum; 1992: 3– 29.
  23. [31]Hackley S Blink reflex studies of attention and consciousness In: Dawson M, Schell A, Böhmelt A, eds. Startle modulation. New York: Cambridge University Press; 1999.
  24. [32]Lüthy M, Schächinger H. Impact of sympathetic activation on the acoustic startle response. Psychophysiology 1998; 35: s54.
  25. [33]Blumenthal T, Chapman J, Muse K. Effects of social anxiety, attention, and extraversion on the acoustic startle eyeblink response. Pers Individ Differences 1995; 19: 797– 807.
  26. [34]Panayiotou G, Vrana S. Effect of self-focused attention on the startle reflex, heart rate, and memory performance among socially anxious and nonanxious individuals. Psychophysiology 1998; 35: 328– 336. 9564752
  27. [35]Carver C A cybernetic model of self-attention processes. J Pers Soc Psychol 1979; 37: 1251– 1281.
  28. [36]Darrow C Differences in the physiological reactions to sensory and ideational stimuli. Psychol Bull 1929; 26: 185– 201.
  29. [37]Lacey J, Lacey B. Two-way communication between the heart and the brain. Am Psychol 1978; 33: 99– 113. 637402
  30. [38]Ray WJ, Cole H. EEG alpha reflects attentional demands, beta reflects emotional and cognitive processes. Science 1985; 228: 750– 752. 3992243
  31. [40]Grillon C Startle reactivity and anxiety disorders: aversive condition, context, and neurobiology. Biol Psychiatry 2002; 52: 958– 975. 12437937
  32. [41]Grillon C, Morgan CA. Fear-potentiated startle conditioning to explicit and contextual cues in Gulf War veterans with posttraumatic stress disorder. J Abnorm Psychol 1999; 108: 134– 142. 10066999
  33. [42]Miller M, Litz B. Emotional-processing in posttraumatic stress disorder II: startle reflex modulation during picture processing. J Abnorm Psychol 2004; 113: 451– 463. 15311990
  34. [44]Hamm A, Cuthbert B, Globisch J, Vaitl D. Fear and the startle reflex: blink modulation and autonomic response patterns in animal and mutilation fearful subjects. Psychophysiology 1997; 34: 97– 107. 9009813
  35. [45]Merckelback H, deJong PJ, Leeuw I, VanDenHout MA. Startle responses of spider phobics to masked stimuli: a pilot study. Int J Neurosci 1995; 81: 169– 175. 7628908
  36. [46]Morgan CA, Grillon C, Southwick SM, Davis M, Charney D. Exaggerated acoustic startle reflex in Gulf War veterans with posttraumatic stress disorder. Am J Psychiatry 1996; 153: 64– 68. 8540594
  37. [47]Grillon C, Morgan C, Southwick S, Davis M, Charneuy D. Baseline startle amplitude and prepulse inhibition in Vietnam veterans with posttraumatic stress disorder. Psychiatry Res 1996; 64: 169– 178. 8944395
  38. [48]Ornitz EM, Pynoos RS. Startle modulation in children with posttraumatic stress disorder. Am J Psychiatry 1989; 146: 866– 870. 2742011
  39. [49]Orr SP, Lasko N, Shalev A, Pitman RK. Physiologic responses to loud tones in Vietnam veterans with posttraumatic stress disorder. J Abnorm Psychol 1995; 104: 75– 82. 7897056
  40. [50]Grillon C, Morgan CA, Davis M, Southwick SM. Effects of experimental context and explicit threat cues on acoustic startle in Vietnam veterans with PTSD. Biol Psychiatry 1998; 44: 1027– 1036. 9821567
  41. [52]Hamilton M The measurement of anxiety states by rating. Br J Med Psychol 1959; 32: 50– 55. 13638508
  42. [53]Hamilton M A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23: 56– 62. 14399272 PMC495331
  43. [55]Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 41: 561– 571. 13688369
  44. [56]Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State–Trait Anxiety Inventory (Form Y). Palo Alto, CA: Consulting Psychologists Press; 1983.
  45. [57]Osgood CE, Suci GS, Tannenbaum PH. The measurement of meaning. Urbana: University of Illinois Press; 1957.
  46. [58]Ornitz EM, Russell AT, Yuan H, Liu M. Autonomic, electroencephalographic, and myogenic activity accompanying startle and its habituation during mid-childhood. Psychophysiology 1996; 33: 507– 513. 8854737
  47. [59]Borkovec T, Inz J. The nature of worry in generalized anxiety disorder: a predominance of thought activity. Behav Res Ther 1990; 28: 153– 158. 2183759
  48. [60]Lang PJ, McTeague L, Cuthbert B. Fear, anxiety, depression, and the anxiety disorder spectrum: a psychophysiological analysis In: Treat T, Bootzin R, Baker T, eds. Psychological clinical science. New York: Psychology Press; 2007.
  49. [61]Borkovec TD, Sharpless B. Generalized anxiety disorder: bringing cognitive behavioral therapy into the valued present In: Hayes S, Follette V, Linehan M. eds. New directions in behavior therapy. New York: Guilford Press; 2004; 209– 242.
  50. [62]Davis M, Walker DL, Lee Y. Neurophysiology and neruopharmacology of startle and its affective modulation In: Dawson ME, Schell A, Böhmelt A, eds. Startle modulation. New York: Cambridge University Press; 1999: 95– 113.
  51. [63]Lee Y, Davis M. The role of bed nucleus of the stria terminalis in CRH-enhanced startle: an animal model of anxiety. Soc Neurosci Abstr 1996; 22: 465.
  52. [64]Borkovec TD. The nature, functions, and origins of worry In: Davey GCL, Tallis F, eds. Worrying: perspectives on theory, assessment, and treatment. New York: Wiley; 1994.
  53. [66]Bradley MM, Lang PJ, Cuthbert BN. Emotion, novelty, and the startle reflex: habituation in humans. Behav Neurosci 1993; 107: 970– 980. 8136072
  54. [67]Hinde RA. Behavioral habituation In: Horn G, Hinde RA, eds. Short term changes in neural activity and behavior. Cambridge, England: Cambridge University Press; 1970: 3– 40.
  55. [68]deJong PJ, Merckelbach H, Arntz A. Eye blink startle responses in spider phobics before and after treatment: a pilot study. J Psychopathol Behav Assess 1991; 13: 213– 223.
  56. [69]deJong P, Visser S, Merckelbach H. Startle and spider phobia: unilateral probes and the prediction of treat effects. J Psychophysiol 1996; 10: 150– 160.
  57. [70]Vrana SR, Constantine JA, Westman JS. Startle reflex modification as an outcome measure in the treatment of phobia: two case studies. Behav Assess 1992; 14: 279– 291.

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Authors
Ray, W. J., Molnar, C., Aikins, D., Yamasaki, A., Newman, M. G., Castonguay, L., & Borkovec, T. D.
Affiliations
Pennsylvania State University (US)
Corresponding author
Ray, William J.
ORCID
Venue
Depression and Anxiety
Publisher
Hindawi Limited
Published
2009-02
Volume
26
Issue
2
Pages
147-154
ISSN
  • 1091-4269 (ISSN-L)
  • 1520-6394
DOI
10.1002/da.20479
PMC
PMC6707516
OpenAlex
W2072416381
Cited by
117
References
7
Citations by year
2026: 5 · 2025: 5 · 2024: 8 · 2023: 6 · 2022: 4 · 2021: 5 · 2020: 6 · 2019: 41 · 2018: 1 · 2017: 2 · 2016: 8 · 2015: 2 · 2014: 7 · 2013: 2 · 2012: 6
FWCI
4.09
Type
journal article
Language
en
Open access
Licence
Locations
  • Depression and Anxiety (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • ScholarSphere (Penn State Libraries) (submittedVersion, cc-by)
Funders
National Institute of Mental Health (MH-58593, R01MH058593, R01MH039172)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
generalized anxiety disorder, startle response, autonomic nervous system, attentional focus, negative affectivity, emotion induction, worry, parasympathetic activation
MeSH terms
Acoustic Stimulation, Adult, Anxiety Disorders, Arousal, Attention, Blinking, Discrimination Learning, Female, Heart Rate, Humans, Imagination, Inhibition, Psychological, Problem Solving, Set, Psychology, Reflex, Startle, Case-Control Studies

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